arXivDaily arXiv每日学术速递 周一至周五更新
arXiv 2502.00366eess.IVcs.CV
收藏

用于增强临床显著癌症检测的前列腺特异性基础模型

Prostate-Specific Foundation Models for Enhanced Detection of Clinically Significant Cancer

Stanford University(斯坦福大学);The Catholic University of Korea(韩国天主教大学);University of California San Diego(加州大学圣迭戈分校)
Jeong Hoon Lee, Cynthia Xinran Li, Hassan Jahanandish, Indrani Bhattacharya, Sulaiman Vesal, Lichun Zhang, Shengtian Sang, Moon Hyung Choi, Simon John Christoph… 展开作者

Jeong Hoon Lee, Cynthia Xinran Li, Hassan Jahanandish, Indrani Bhattacharya, Sulaiman Vesal, Lichun Zhang, Shengtian Sang, Moon Hyung Choi, Simon John Christoph Soerensen, Steve Ran Zhou, Elijah Richard Sommer, Richard Fan, Pejman Ghanouni, Yuze Song, Tyler M. Seibert, Geoffrey A. Sonn, Mirabela Rusu

AI总结:

本文提出前列腺特异性视觉基础模型ProViCNet,利用多机构MRI和TRUS数据及对比学习实现临床显著前列腺癌检测,性能优于放射科医生,并与PSA结合大幅提高特异性以减少不必要活检。

摘要:

准确的前列腺癌诊断仍然具有挑战性。即使使用MRI,放射科医生的特异性较低且观察者间差异显著,导致在识别临床显著癌症时可能出现延迟或不准确。这导致大量不必要的活检以及漏检临床显著癌症的风险。在此,我们提出前列腺视觉对比网络(ProViCNet),即针对磁共振成像(MRI)和经直肠超声成像(TRUS)的前列腺器官特异性视觉基础模型,用于全面的癌症检测。ProViCNet使用来自六个机构的4,401名患者进行训练和验证,作为一种基于放射学图像的前列腺癌检测模型,依赖于由活检确认的放射科医生标注引导的斑块级对比学习。ProViCNet在多个内部和外部验证队列中表现出一致的性能,受试者工作特征曲线下面积值范围为0.875至0.966,在mpMRI的阅片者研究中显著优于放射科医生(0.907对0.805,p<0.001),同时在TRUS上达到0.670至0.740。我们还将ProViCNet与标准PSA整合,开发了一种虚拟筛查测试,并证明我们能够在检测临床显著癌症时保持高灵敏度,同时将特异性从15%提高到38%(p<0.001),提高了一倍以上,从而大幅减少不必要的活检。这些发现凸显了ProViCNet在提高前列腺癌诊断准确性和减少不必要活检方面的潜力,从而优化诊断路径。

英文摘要:

Accurate prostate cancer diagnosis remains challenging. Even when using MRI, radiologists exhibit low specificity and significant inter-observer variability, leading to potential delays or inaccuracies in identifying clinically significant cancers. This leads to numerous unnecessary biopsies and risks of missing clinically significant cancers. Here we present prostate vision contrastive network (ProViCNet), prostate organ-specific vision foundation models for Magnetic Resonance Imaging (MRI) and Trans-Rectal Ultrasound imaging (TRUS) for comprehensive cancer detection. ProViCNet was trained and validated using 4,401 patients across six institutions, as a prostate cancer detection model on radiology images relying on patch-level contrastive learning guided by biopsy confirmed radiologist annotations. ProViCNet demonstrated consistent performance across multiple internal and external validation cohorts with area under the receiver operating curve values ranging from 0.875 to 0.966, significantly outperforming radiologists in the reader study (0.907 versus 0.805, p<0.001) for mpMRI, while achieving 0.670 to 0.740 for TRUS. We also integrated ProViCNet with standard PSA to develop a virtual screening test, and we showed that we can maintain the high sensitivity for detecting clinically significant cancers while more than doubling specificity from 15% to 38% (p<0.001), thereby substantially reducing unnecessary biopsies. These findings highlight that ProViCNet's potential for enhancing prostate cancer diagnosis accuracy and reduce unnecessary biopsies, thereby optimizing diagnostic pathways.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

↑